Understanding potassium

Anyone following Freddd’s methylation protocol or any other high dose methylation support should know there’s a risk of creating a potassium deficiency which is potentially lethal. It’s called hypokalemia. Muscle cramping is one of the warning signs and I’ve experienced some of those cramps. I’m currently supplementing with 2.2 g of elemental potassium a day and suspect I still need more, so I’m trying to understand the potassium issue in more depth before taking more potassium.

It’s a complicated subject because both too little and too much potassium is dangerous. For this reason, Andy Cutler recommends you not exceed 1 g of supplemental potassium without “doctor supervision”. While I appreciate the warning and take it seriously, I’m saving this precious oxymoron ‘doctor supervision’ as the title for a new post about my pathetic experience with doctors.

The more I learn, the more I think potassium may be one of those cornerstone supplements for me and for many others. Most of the information on this page comes from Stephanie’s posts on FDC who just happens to be studying and experimenting at the same time as I am:

These observations are all from the book “Potassium Nutrition” ($4 kindle book on Amazon) unless otherwise noted – the author explores all the research relating to dietary potassium deficiency leading to a functional deficiency, and how it applies to many chronic disease processes (he essentially includes chronic fatigue and fibromyalgia as well). In some cases these correlations have not been examined before, in part because conventional medicine overlooks the role of potassium, and the labs that are typically used to assess potassium and electrolyte levels don’t give the entire picture.

There really isn’t a good way to assess the overall level of our potassium status (it is possible but the tests to determine this aren’t really available – it requires special equipment which is very expensive). Even measuring RBC potassium and sodium doesn’t give the complete picture – for one thing, our bodies will lose potassium from muscle cells at a far greater rate than blood cells- and this is why muscle cramps and weakness are common symptoms.

Potassium gluconate (one of the most available supplement forms) goes into solution easily to give potassium ions (which is the electrolyte), and the gluconate part is metabolized in the liver to create bicarbonates. Bicarbonates are also electrolytes. So this is similar to supplementing potassium bicarbonate.

Potassium bicarbonate is alkalizing and it helps to prevent calcium loss that can be caused by a functional potassium deficiency…. which are both desirable for most people – particularly given modern diets. Potassium bicarbonate is also the form most similar to what you get from eating vegetables. However potassium bicarbonate will tend to lower blood pressure.

My sense is that salt cravings are a way to help raise blood pressure – it’s actually the chloride in salt that tastes salty and raises blood pressure. My blood pressure was definitely getting lower after cutting back hugely on salt and supplementing with potassium bicarbonate over the course of a few days. Note that one teaspoon of potassium bicarbonate contains roughly 2000 mg of potassium.

If you have low blood pressure, it’s preferable to supplement primarily with potassium chloride – and use potassium bicarbonate (or potassium gluconate) to help balance pH (if urine pH becomes acidic). Too much bicarb will be too alkalizing and will lower blood pressure so it needs to be balanced with the chloride – which does the opposite.

Chloride is another important electrolyte – it gives the salty taste to salt and tends to raise blood pressure (loss of chloride usually accompanies a potassium deficiency because chloride is secreted to maintain serum pH). So naturally, potassium chloride tends to raise blood pressure, and tends to be acid forming. Potassium chloride will also help to raise the cell levels of potassium faster than potassium bicarbonate. This seems to make sense given their relative effects on electrolyte balance and blood pressure and pH.

An ideal ratio of total daily intake (diet and supplements) of potassium to sodium is said to be something like 5:1. But, a low potassium to sodium ratio is the norm these days – especially if you compare that to the ratio that researchers believe humans evolved on… potassium sources were plentiful and the mainstay of diet, whereas sodium was very scarce. Paleo man probably had at least a 10:1 potassium to sodium ratio in his diet, and many put that estimate much higher. So even people who eat a relatively healthy diet these days aren’t necessarily immune to the effects of a lower ratio – given the availability of sodium, and the relative scarcity of high potassium foods from plant sources…, together with all the other influences that affect our acid-alkaline balance and electrolyte balance in modern life (i.e. toxicities).

Now, even getting to a ratio of 2:1 or 3:1 is better than the average human who eats a lot of processed foods. Of course, there are many other factors besides this ratio to consider – including the source of potassium in food and whether it forms bicarbonates and is therefore alkalizing (this would be the potassium from plant sources, especially leafy greens) – or whether it makes chloride and is therefore acidifying (from protein sources of potassium), so this relates to our pH balance.

If a person is very deficient (at the cell level), then it can take a long time for general healing to occur… maybe 6 months to a year or more. However, if you’re supplementing – say 1 gram with each meal (~3 grams/day) – then you should be able to correct the deficiency state in a matter of weeks, assuming you lower sodium appreciably and otherwise eat a decent diet and you’re getting enough magnesium, taurine etc (according to Wikipedia, “In cells, taurine keeps potassium and magnesium inside the cell, while keeping excessive sodium out” so, supplementing with taurine – up to 3 grams per day – may be helpful).

Medications, and other things that might cause potassium loss or create acidity (like toxicity from metals and chelating) have to be taken into account as to how much potassium is right for you, and whether you need extra bicarbonate to neutralize acidity. It’s ideal to get our potassium from food of course, but it seems that can be kind of hard to do, especially for someone dealing with toxicities.

Hence, supplementing with potassium chloride and potassium bicarbonate as indicated can help improve our K to Na ratio, and overcome the effects of “poor” dietary influences, medications, toxins etc. It’s worth considering that the author of this book suggests that, “our bodies don’t store potassium”…but we need to continually take in a lot of it for healthy metabolism, nerve function etc.

What becomes pertinent is our ability to regulate the level of potassium in serum and in cells… Which leads to the topic of aldosterone – which is essential for regulating serum potassium… The question being, is it possible one might be low in aldosterone at least in part because we are functionally deficient in potassium? And will slowly improving this ratio of K to Na allow our aldosterone levels to rise along with potassium intake?

The info in this book suggests this is generally this case (short of permanent atrophy of the part of the adrenal gland that produces aldosterone – or I suppose secondary adrenal insufficiency will prevent the appropriate signaling for the release of adrenal hormones, no matter how much potassium is available). Regardless, one shouldn’t drastically increase potassium intake without keeping an eye on our serum potassium to ensure that our body is handling it properly – as Andy has told us.

If we don’t have adequate aldosterone, we can go high on serum potassium… And there are other factors too, certain medications and kidney function factor in. By the way, the same could apply to cortisol – that is, secretion may rise as potassium is increased.

Increasing methylation may have the effect of pulling more potassium into cells that are deficient… at the expense of serum potassium – causing low serum potassium (this is Rich Van K’s theory). According to this theory, people with chronic fatigue caused by methylation block have fewer cells than normal. Ramping up their methylation cycle supplies the missing folate needed to make new DNA and suddenly the body can make new cells. This is what we call ‘healing':

All of a sudden, the cells now have enough DNA to overcome the arrest of the cell cycle, and their rate of cell division goes up, making new cells more rapidly. These new cells require potassium, and their membrane pumps start pumping it in from the blood plasma. Unfortunately, since the existing cells, which contain 95% of the body’s potassium inventory, are already low in potassium, there is no cushion or buffer for the blood plasma potassium level, and if it is not augmented by increased potassium intake from the diet or supplements, the PWC’s blood plasma potassium level drops, resulting in hypokalemia.

While both the cell and serum levels of potassium are important, it’s the serum level of that can be very dangerous if it goes out of the so-called “normal” range. So, if you are ramping up your methylation cycle, keep a bottle of potassium around and know the symptoms of hypokalemia (weakness, lack of energy, muscle cramps, stomach disturbances, an irregular heartbeat, and an abnormal EKG) and hyperkalemia (muscle weakness, slowed heart rate, and abnormal heart rhythm).

A few words from the author himself, Charles Weber, MS. We asked the author of Potassium Nutrition, to review the summary above for accuracy and this is his response:

I did not see anything in the URL you sent that was obviously invalid. The body is a complicated soup, though, and it is easy to get things wrong. If a person’s kidneys have not been damaged, by poison for instance, that person can do some great nutritional blunders with respect to potassium and still stagger through. Healthy kidneys can handle some bizarre ratios since they have much more capacity than they need. The only circumstance that I know of that is desperately dangerous is the interaction between potassium and thiamin (vitamin B-1). If potassium is supplemented it is essential that vitamin B-1 be adequate (see http://charles_w.tripod.com/kandthiamin.html ). And of course, if the kidneys have been damaged in such a way as to be unable to excrete potassium there is some danger from supplements. This can easily determined by blood analysis.

Very nice article. I would add that in the Paleo days, people ate about 11 grams of potassium per day and about 3.5 grams of sodium. Now days we lucky if we get 1 gram of potassium and most people load up on sodium 4-5 grams. If you do alot or cardio you deplete your body of minerals due to acidic blood buffering effect. Besides Potassium bicarbonate you can make and drink Magnesium bicarbonate very easily. Since low potassium and low bicarbonates most likely cause high calcium serum, your arteries are plagued with calcium deposits. You need magnesium to dissolve them. Magnesium bicarbonate is an excellent suppliment for this purpose.

Hi, I can only comment under an existing post. I have spent a lot of time reading this site in the past week and very surprised how supplementing with potassium is such a big focus whenever cramping, pain or salt cravings is noticed….all signs of magnesium deficiency, which is extremely common and potassium is apparently not to be supplemented without first getting magnesium levels high enough as it regulates both low potassium and calcium. By adding the potassium without magnesium, it’s creating further depletion of our most crucial macro-mineral.

Up until a few weeks ago, the pain in my hands and feet were severe, I felt like I was walking on broken bones and I could barely use my hands due to stiffness, swelling and pain. I thought it was arthritis from so many past injuries of fractures, sprains and other injuries.

I have had fibromyalgia since childhood (52yrs old now) plus myofascial pain condition which had become so severe that the past year I’ve had chronic muscle spasms in my torso which were excruciating and often had me to scared to breathe deeply in bed, as the spasms were always worse then.

My balance has always been bad and I often have accidents or fall over but it had become so bad, that I’d fall over for no reason!

Cognitively, I have spent the past few years terrified I was developing early dementia as I spent so much time forgetting what the hell I was looking for. I couldn’t find words, forgot things as soon as I was told or read them and I was just not ‘me’ any more. I couldn’t really focus 100% on anything.

I’ve got a long way to go BUT my saving grace has mainly been huge doses of magnesium, spread out through the day. If I slack off the spasms start niggling. I can use my hands with only a little pain now and no swelling even in humid weather. My feet still hurt me but MUCH improved. I wasn’t expecting relief from hands or feet and it’s so exciting!!!

I haven’t fallen over in 2 weeks and I don’t feel unsteady. My hands no longer have a tremor. I’m not as easily confused or in a perpetual brain fog or as forgetful.

A wonderful relief was a huge reduction in waking myself up half a dozen times with the noise I made by grinding my teeth. I hardly do that now.

I take about 8-10 Source Naturals Magnesium Malate, as well as transdermal Magnesium Chloride
oil but it was better when I was taking my 5000IU of Vit D3 daily as well before I ran out.

One thing people are never told when taking Vit D3 is that it depletes magnesium and it has to be taken with it for proper absorption. I also take Zinc and B Complex

I have started to supplement with Methyl B12 5000 transdermal patches but it was the magnesium that made the biggest difference and most notable change if I forget to take as much.

Happy to provide links for you. It’s one of the recommended treatments that has helped some with CFS and Autism.

glad you are getting such great benefits from magnesium Michelle! I don’t talk much about magnesium because it is so widely reported and I also take large quantities myself. I try to focus my writing on issues that are little-known or difficult to find information about and especially what I’m experiencing personally… I’ve recently cut back a lot on magnesium because I don’t want to take it with meals as it reduces stomach acid and must hinder digestion somewhat. Thanks for the vitamin D/magnesium reminder. Hope you can find out what’s at the root of your magnesium deficiency!

The link you provided to potassium bicarbonate info is no longer available. Do you have any other links that suggest that 1 teaspoon = 2,000mgs potassium? It seems high, and some of that has to be bicarbonate.

Sorry, I remember that link was hard to find. I can tell you however that potassium bicarbonate is very strong stuff – a small quantity has a big impact on urine alkalinity and also very easily irritated my stomach. I would tend to believe that measure is accurate.

Hi Eric. I found this article discussion fascinating because I am about to embark on methylation and wanted to get my potassium up first. However, I feel dizzy, weak and get panic attacks with supplementation, or after sprinkling potassium chloride on my food, and was wondering the reason for this.

The aldosterone relationship to potassium intrigues me. I recently starting taking maca and wonder how this will effect aldosterone and need for potassium. I am also going to read the book to find more out about B1/potassium relationship.

At this point, I am trying taurine- also helps me sleep and relax. I am hoping it will help cut back my need for supplementation by facilitating transport of ions in and out of the cell. I see your last post was a year ago: How are you doing on the taurine?

hi Helen, I don’t have any complaints about the taurine, I’m still taking it. I wouldn’t take the potassium if you react like that to it. I’ve no idea why. You could also try a different form of potassium like potassium gluconate. Better yet, potassium rich foods… I’ve stopped supplementing potassium myself.
-e

Thanks so much for your response, Eric. May I ask why you believe it is no longer necessary to supplement with potassium? The reason I ask is that I just started detoxing (actually by accident): first with a psylium-herbal supplement, then with Maca root- It was like a weight had been lifted and I was all of a sudden so hungry after having no appetite for a year!

But with the increased appetite I also felt so low on electrolytes and had a nervous exhaustion. So I tried increasing potassium in my diet (and other minerals) but still felt the nervous exhaustion and started doing literal cookie crumb-amounts of methyl B12 and methylfoalte to complete my the detox I had started because I felt the pslium fiber was too dehydrating and the Maca was too excitatory.

Now with the cookie crumbs of the B12 and methyl folate I feel more depleted from electrolytes than ever but also many positive effects too. I had read that these nutrients help increase cell reproduction at high levels, increasing demand for potassium and other nutrients. I am hoping that if I keep my dosage low for a long period of time, this demand will level out somehow. I am hoping that was your experience.

So many other people I read about on these nutrients are supplementing with high doses of potassium that I could NEVER reach or sustain with my sensitivities. But I want to stay on these supplements (at least in tiny amounts) and can only down so much potassium/mineral rich food and supplements a day. Do you feel that some of your mineral needs have leveled off to more managable amounts? Thanks, Helen

Some individuals with either compromised kidney function or a mutation for Hyperkalemic periodic paralysis should avoid supplementation of potassium. These disorders are very serious but can be managed through diet and emergency levels to lower serum potassium levels. For individuals with Hyperkalemic periodic paralysis even minor shifts in serum potassium levels can go quickly from muscle weakness to paralysis and even cardiac arrythmias. . Serum levels do not have to be extremely high for this to occur. Glucose tabs, juice and even inhaled steroids can quickly bring serum levels down enough to eliminate these symptoms.

Hi Helen, after reading up on this page, I did start the Potassium Gluconate and muscle tested for times and doses. My subconscious was wise and did not have me take a bunch of potassium at one time. For the first couple of weeks, I needed usually one potassium gluconate tab in the am and with meals, then the amount I needed started to decrease. Guess I was getting replete at the cellular level. I am surprised at how few supplements I need to take these days, sometimes none at all, but still with the B12 injections every few days, and/or if I am doing something strenuous, like returning to consecutive 12-hour shifts at age 57. Incidentally, I did receive the potassium bicarb several days after starting on the potassium gluconate, but I never have muscle tested positively for using it after receiving it, even though I think tested positive when ordering it, probably because I did not have the gluconate in my home at the time when I ordered it. Guess my body prefers the gluconate for now. Hope you get your supps sorted out…..

Thanks so much for relating your experience and insight, Beverly. I think you are right- there may be a form of potassium out there that I can tolerate. I find it interesting that you too feel your need for it varies from day to day agree it is best to let the body determine daily needs for this nutrient. And always starting very low is a great idea. Thanks for the encouragement! Helen

Trying to figure out my potassium needs, since trying to bring down blood pressure. Have some potassium bicarbonate on order per your suggestion. Just picked up some potassium gluconate. Had been using potassium citrate, but that just made me feel odd in higher doses, and I don’t think it even began to bring down my blood pressure. On the aggressive B12/folic acid protocol. Thanks for all this info. I knew to increase potassium with the B12 protocol, after being on the Pernicious Anemia/B12 Deficiency FB page for a while, but I was curious about the pathology and the reasons for it. Thanks for explaining that…..makes sense….do eat mostly fruit, meats, kefirs, veggies (usually from own garden.)

I’m having such a hard time understanding how everything works together! About 2 weeks ago my B12 lab came back at 182. My doctor told me to start with 2000mcg a day. I happened to have cyanocobalamin 1000mcg pills and started on that twice a day. At first it made me very tired. I ordered what I THOUGHT was methylcobalamin and when I got it it was only “sublingual cobalamin”. I started on that twice a day, didn’t have the fatigue issue but now the faint heart palpitations with the other kind were getting worse with every pill I took. About a week into supplementing it was terrible. It started with muscle tightness in my neck, where it felt like they would cramp up if I just moved the wrong way. Then muscle weakness, heart palpitations, tightness in my chest and a general unwell feeling. That was 3 days ago and I am still trying to recover. Someone told me that it may be a potassium issue and so I started eating potassium rich foods as much as possible. Feeling slightly better over all, my heart still feels off and now I have a monster headache. My serum potassium level was 3.6 in May, I can only imagine what it is now.
I don’t quite understand how the other things correlate, my chloride was 108 (high range 107), and sodium normal low.
I tried to call my doctor to talk about it but she seems completely unconcerned and simply said to stop taking the B12. I called again later to see if I could add potassium to other labs she had ordered and spoke with her nurse who basically said, “if you feel so uncomfortable, you should go to the ER”. Thanks for the help, lady.
This is all so confusing to me, I don’t know what the real issue is or how to fix it!

your experience with MDs sounds like mine, no surprise there! you might try potassium gluconate. For a long time I was taking 23 potassium gluconate pills per day. Total of around 3 g of potassium… No doctor is helping me. Just be very careful to make small changes each day.

I get constant neck spasms (I guess you could call them ‘cramps’) – all the time from fibromyalgia. I am taking Enzymatic Therapy Krebs Mag-Pot Chelates: has 250 of mag/ 100 of potassium. Do you think that’s enough potassium, or do you think I may need more?

I’m doing the B12 protocol, but got pretty confused; there was so much to read through and process. I thought that you & Freddd took large amounts of the 2 forms of B12 – right? Can you tell me how many MG’s you took?

I had begun on Jarrow 5,000 mcg and took 5 sublingually with Source Naturals Dibencozide 10 mgs. 4 sublingually for 45 minutes.

However, the protocol summary gives low amounts. I WANT TO HEAL AND WILL DO WHAT IT TAKES. I am past the end of my rope with this.

I am also trying to help cure doctor-induced nerve damage, and read where B12 helps to heal that in large amounts (saw in a study on ProHealth).

All of these amounts I’ve arrived at slowly over time starting very small. Same goes for potassium, I took a little more slowly over time until my cramping was controlled… I often feel at the end of my rope too!

May God truly bless you and Fredd for sharing your stories, and for helping those of us trying to find our way through this maze. Your story provides hope; something I think those of us sick for so long with these disorders need. I printed out your list of supplements, so I can go through it carefully.

I sat all day today and read through your story (have to re-read many times, and highlighted important points, and didn’t reach the end). I had no idea that B12 was involved in 600 processes in the body, as well as many other facts I was unaware of.

I had read up on nutrition for years, but never had I heard of “methylation” – and the importance of it. I am so adamant that my family never goes through what I have, that I bought each of them a bottle of mb12 & adb12. I printed out the first page of your story to give to each of them, as well as my father, who has foot-drop.

I am hoping this will work, as I’ve tried almost everything else. But the symptoms seem to fit. I had a lot of mercury fillings removed, (after having them for years) but the dentist didn’t do the removal properly, so I’m certain I inhaled & swallowed all the dust. I am doing Andy Cutlers ALA protocol, and implemented things like lipid replacement therapy that Radio from ProHealth uses. He sent me the link to your article, which I am very thankful for.

I had severe headaches tingling almost 4 months back and after a month of wasting time doctors figured out B12 Def. I was given Mb12 many times along with gram doses of folic acid. My headaches went within 4 days and my mood became better. But within 2 weeks I started developing joint pain etc… It has worsened since and I hurt my back also… Now its 3 + months and all my original symptoms of Nerve/headache is gone but my back muscles and other join weakness (Without pain) has worsened. I have stopped all folic acid 15 days back and my B12 Injections were stopped almost 1.5-2 months back… It has similarities to potassium / electrolyte… depletion since taking pot supps helps .. I have not tried potassium supps more than 1 G per day… I am at loss and depressed not able to go to work… Can someone help… Can weakness due to potassium depletion persist even after stopping B12/Folate. If so what is the best mechanism to increase…it… What is the best way to get out of this weakness… I am not diagnosed with CFS etc. I am not sure if I have any…. May be my body was already on low Potassium and the B12 treatment + Multi gram Folic Acid might have triggered Potassium deplesion… But even after discontinuing …it is still there.. Some one please help

Well, I take around 5g of potassium gluconate per day and still getsome muscle cramps… I would try titrating up your potassium very slowly and carefully. Take it with meals to avoid hurting your stomach and try to split it up across meals as best as you can. Watch carefully for any symptoms of too much potassium. Ideally, you don’t want to take large doses of b12/folate and then suddenly quit. You’ll be better off increasing slowly and steadily so you can work out your potassium issues over time so that you are doing everything in a sustainable way.

As you suggested I will slowly increase potassium and watch. I am very glad and thankful that you replied. Wish you and everyone including me heal well. I will post based on my experience so that someone with similar symptoms could possibly take better decisions. Life…has become a big game… but I am sure one day at least our next generations will be able to lead a better life due enhancements in techs. Just need to at-least hold on till then and do everything to get betters..(doctors as you said are not helping..No one here in my area knows anything about methylation block, potassium need etc)…and people like you aid in that.. Thank you.

In the few days I tried… Few things I noticed. When I increase potassium the symptoms improve in the short term, but need of potassium keeps growing to keep up with the same level of muscular strength. Also peeing has increased… Weakness starts with a pee typically and then potassium ..pee potassium pee this goes on… till I get afraid at 2 g of elemental potassium (Dissolved KCL powder with food). Overall strength has improved but something is tricky with this potassium. Do you take elemental Potassium 5g or Potassium gluconate 5g. My problem is I dont have any lever to control methylation (Assuming my symptoms are due to methylation) Since I am not taking any supplements….Only Potassium.. My B12 levels are very high and so is my folate level. Any similar experience ? Any ideas on how to manage. Also I have relative weakness half day and then more strength the rest of the day (All this started only after taking B12 injections with folates)…

“My problem is I dont have any lever to control methylation”
Niacin (not flush-free type) will turn down your methylation – I take 100 mg at bedtime.

I don’t do any blood testing because I think the tests are fairly meaningless. So what if you have high levels of something in your blood that should be getting into your cells and isn’t. You can have a deficiency of something that a blood test shows high. That’s one of the main issues with potassium deficiency I believe, that some people have trouble getting it into the cells where it’s needed.

Check your chloride level if you are having symptoms such as muscle twitching or spasms, breathing problems, weakness, or confusion.

I guess it’s time for me to up my intake of salt. I don’t really eat out at all, and am pretty strict paleo. I’ve been gluten free for the last 40 days. I never realized it, but baked goods contain lots of sodium. In fact, a dunkin donuts muffin contains twice as much salt as large french fries at mcDonalds.
I’m very excited to do some diet tweaks with sodium chloride in mind! I will get some Now Foods potassium chloride as well.
Thanks again for such a great resource!
Mike

My recent light-bulb moment was when I realized that after 3 days of mega-doses of methyl b12, I’d get grinding tension headaches and muscle cramps.

I’m day 3 into taking NO b12. high potassium foods, and low salt. The only supplement I’m taking is jigsaw magnesium. However, based on what I’ve read today, I’m upping my salt intake.
I have a new-patient visit with a functional medicine doc in 2 weeks.
Any tests you can suggest I ask about pertaining to this whole potassium thing, given my methylation issues?
Thanks,
Mike

How common is potassium deficiency? I suspect more common than you think!
I was chatting with a 53 year old woman who has rheumatoid arthritis. For years now, she has suffered from some muscle twitching and some muscle cramping. Her doctor said her blood potassium level was normal. End of discussion. That’s pretty much identical to what happened to me with my primary care doctor.

Question:
What tools are available to normal doctors pertaining to low potassium?

What a great thread!
Questions:
1. Could someone have potassium induced muscle cramping and/or muscle twitching if blood potassium levels are at 4.1-4.3?
2. I’m on paleo and have a very very low sodium intake. Is this a bad idea as I bump of the qty of potassium foods?
Thanks for any thoughts,
Mike

My impression is that blood potassium levels are not very meaningful, so that would be a yes… and also that the low sodium intake is a very good thing. At times in the past I have used saltwater because my adrenal function is low but that’s a separate issue. If your blood pressure is low you may also need the chloride from salt but you could get that by supplementing with potassium chloride instead.

I got an interesting comment there: “Over-restricting salt is a prime reason for getting low potassium because it leads to excessive aldosterone production (which retains sodium while over-excreting potassium, magnesium and calcium). You won’t fix the problem by eating more potassium (this will make it even worse), you have to salt more. Also ensure that you got enough calcium in your diet (i.e. from dairy)..

I responded: “Funny you mention “aldosterone” While researching my 23andme methylation results, I came across this: “ACE Gene: This enzymes leads to high levels of angiotensin II which causes an increase in aldosterone. High aldosterone leads to increase potassium loss in the urine and increased sodium retention.” My doctor dismissed this saying if this were relevant, I’d have high blood pressure, which I don’t. An MAO-A mutation makes this worse. (which I have). I am hetero for ACE and homo for MAO-A.

That’s pretty interesting Mike! I also have the the same exact pattern you do for those two genes. However, a 24-hour urine collection test by Meridian Valley showed my aldosterone levels to be normal. Now that you mention it, I think my cramping has gotten worse since reducing my salt intake and increasing potassium supplementation. However, I was boosting methylation at the same time so I don’t think there’s any way for me to know without doing experiments.

After doing more research and thinking I’ve been wondering if my cortisol supplementation is to blame for my potassium troubles. I’ve been tapering my cortisol so maybe I’ll have an answer soon.

As for salt intake, unless you eat nothing at all from restaurants or prepared food from grocery stores like Whole Foods (in my experience) it’s pretty hard to get salt intake way way down.

Thanks for posting this Mike. It rings a bell for me as well, as I’ve been upping my potassium using potassium salt (chloride) and also increasing magnesium, because my blood pressure has been erratic, despite reluctantly taking a half-dose BP med.

The day I went back for a followup I limited my salt intake big time, and increased my potassium (and a little magnesium), and I could hardly walk because the spasms and cramps were so bad. And on top of that, my blood pressure was the highest it’s ever been! Part of that is the ol’ white-coat’ phenomenon, as it dropped almost 50 points a few hours later, but still…

And since then, just in the last couple of days, I’ve cut back on the potassium salt, and despite my severe muscle loss (like Freddd’s on the PR forum), I’ve been able to “walk”, at least move around the apartment, a little easier.

Any word on Potassium Citrate? My oldest went on that when he had kidney stones at age 11. He’s been on it several years now, long before a doc diagnosed him with B-12 def and MTHFR. I’ve been trying to think through how it’s related.

I’ve been taking 3 g of potassium citrate every day for about a week. I’m happy with it except for the fact that my urine pH is way too alkaline. I’m trying to balance with vitamin C but not having much success. Not sure what to do next…

I accidentally discovered the solution for the pH imbalance. It turns out that D-ribose is strongly acidifying, so, with 15 to 20 g – problem solved! Also discovered that I need this much to keep my energy and body warmth up.

Discovered this accidentally when I started forgetting to take it, and one evening had low energy, so I took 15 g and immediately my body warmed up and I could feel my methylation cranking again…

Wow – that’s a lot of D-Ribose Eric! I get what you mean though, that there seem to be any number of possible rate limiting factors when it comes to methylation. Adding NAC has been hugely helpful for me. I tried D-Ribose many years ago and didn’t notice any effect. Most likely I would notice now, given that my entire system has been “upregulated” Perhaps I’ll get some…

I have to wonder though, exactly what’s happening merely from tweaking our pH (presumably urine pH?) by adding stuff like bicarbonate or more acid… I suppose that’s better than having our pH be way out of range but it’s also possible that it’s not really doing much to adjust our intracellular pH and mostly it’s being eliminated in the urine. At least for myself, I haven’t figured that out to my satisfaction as yet. At the very least, if our pH is apparently “normal” (whatever that is), but if we feel yucky and fatigued, then I have to figure that into my interpretation. I’ve found that I know rather intuitively whether I’m trending towards over-acidity or not… and testing pH tends to confirm that.

At first I thought that was a lot of ribose also, and if you look at the cost, it definitely is. However, if you look at it in terms of the amount of sugar in a cup of juice or an “energy” bar, it’s not that much.

The reason I felt it important to pay attention to urine pH is because Revici found that urine pH was typically all acidic or all alkaline in cancer patients. Healthy people start the day acidic and become alkaline. That crossover used to happen before I started taking large quantities of potassium, so I wanted to correct for that… also worried I might damage my kidneys or some other system if I didn’t.

“In all cases, autoimmune diseases are preceded by breakdown in cellular anabolic performance, and consequently, cellular potassium deficiency is guaranteed in autoimmune disorders. The critical oversight in research literature is that cellular potassium is a by-product of anabolic metabolism.

Dietary potassium sources weakly influence cellular potassium levels because the cellular potassium channels are one way out, not in.

Modest exceptions occur when dietary potassium is encapsulated, chelated into aspartate, orotate forms, or lipid structures that integrate with the cell membrane.“

Have you ever tried potassium aspartate or orotate? After reading the quote you mentioned, about aspartate and orotate forms perhaps having stronger influence on cellular potassium, I wondered about it. Especially as these two forms are easier to acquire than making liposomic potassium would be (I don’t think anyone sells liposomic yet premade). The tiny dose per capsule is a problem though, and I haven’t seen them in powder form. Swanson’s sells the orotate capsules (cheaply, too, looks like), Amazon has them for somewhat higher cost/different brands. Maybe these forms haven’t been on the market long though, there aren’t many user reviews on either of those sites for them.

hi Mary, I haven’t tried the potassium chelates… I thought the first step would be for me to try liposomal vitamin C to see if I can tolerate lecithin and to see if the liposomal trick works well for me. In theory, I don’t mind making my own because I might be making the vitamin C anyway.

Hi Eric,
I’m glad you added Charles’ comments and the caution about adequate B1. I left that out of the original post on FDC to avoid making the topic more confusing… in part because I found it confusing. At least in his book, there is a case where he says one should not take supplementary B1. But it seems that caution applies if there is an existing potassium deficiency. I suppose the upshot is to supplement both, presuming one is starting from a deficiency state.

Your readers might also be interested to know that in addition to magnesium and taurine, inositol can help raise cell levels of potassium. However in my further reading on the topic, the limiting factor when it comes to cellular uptake of of potassium, is largely about the integrity of the cell membrane. Supplemental potassium may simply be lost in the urine (or cause serum levels to rise if there is poor kidney function or insufficient aldosterone) when the potassium pumps on the cell membrane are not functioning efficiently, as it likely the case for CFS sufferers, or those who are otherwise poisoned by mercury. This does relate to methylation status, but I think there’s more to it than that.

In Amalgam Illness, Cutler states: “Mercury selectively catalyzes the oxidation of cell membranes. This destroys essential fatty acids and membrane constituents like phyospatidylserine and phosphatidylcholine at an accelerated rate. The alternation in membrane components interferes with cellular signaling, interferes with cell function, renders the cells more susceptible to oxidative stress, and favors other pathological processes.”

Cutler also discusses potassium in the Hair Test book: “Hair potassium does not reflect dietary intake or body burden even when mineral transport is normal and orderly. Low hair potassium suggests the possibility of low thyroid function. Urine potassium generally correlates with dietary intake, and red blood cell potassium generally correlates with body inventory. Serum potassium is primarily a marker of adrenal/kidney interactions. High hair potassium may reflect excessive aldosterone activity. Low body potassium can cause general weakness, fatigue, thirst, constipation, weak reflexes and heart beat irregularities, the most common of which is a racing heart (tachycardia). Low potassium can be due to certain types of diuretic medications or to a diet low in vegetable matter. Mercury deranged mineral transport often causes functionally low body potassium levels by interfering with the concentration of potassium into cells by cell surface pumping proteins. However this is not reflected by the hair potassium level – red blood cell potassium is the relevant measure.”

Note that Mr. Weber states that the body will selectively keep potassium levels in red blood cells above that of muscle cells in the event of a deficiency (I think I mentioned that in the original post)… so measuring RBC potassium doesn’t tell the whole story either. But it can still provide some indication.
In the next section in the hair test book about key mineral ratios as they appear in hair test results, Cutler mentions the concept of metabolic typing and so-called “fast” and “slow” oxidizers, and that some practitioners suggest that certain nutrients are helpful or will increase dysfunction, depending on your oxidation type, but he doesn’t necessarily agree with these theories. I mention this because in my further reading, I’ve found that potassium is one of the nutrients that theoretically should not be supplemented by fast oxidizers. However, it would be indicated for slow oxidizers. The distinction has to do with the rate that the cell uptakes and utilizes glucose and other nutrients like potassium. I think this would be analogous to methylation rates, and it also has to do with adrenal function. Early stages of adrenal fatigue that are characterized by high cortisol, as well as over-methylation, can push too much potassium into the cell. However, I would guess that most of your readers (i.e. CFS sufferers) are probably experiencing the opposite – impaired adrenal function, impaired methylation and low cell levels of potassium. This also implies that the cells likely have a lower pH level – meaning excess acidity and therefore toxicity.

For myself, these added insights have led me to up my dosages of antioxidants and essential fatty acids. This should better protect cell membranes and therefore increase potassium uptake.
~Stephanie

This process of figuring out potassium has become a little messy for me. In a short time period, I reduced my salt intake and increased taurine and potassium by adding potassium chloride and subtracting some potassium gluconate.

Then I started getting very spacey. Not lightheaded as I do with methylation and not brain fog, but spaced out. It seems to come on and go away rather quickly which should make it easy for me to figure out what’s causing it, but so far I can’t pin it down.

I think it’s the taurine, so I’ve reduced that and to be safe, reduced my potassium gluconate a little as well. What a nuisance when I was hoping for a miracle right out of the gate, lol.

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"...nothing ever goes away
until it has taught us what we need to know."

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About

My name is Eric - I‘m 46 and saw a doctor for fatigue at 17. I lived fairly normally if a little subdued by lack of endurance at times. But then, 12 years ago I fell into a nosedive after moving to South Florida. Now, I know heavy metal toxicity is a significant source of my troubles along with genetic methylation cycle dysfunction. I spent 18 months chelating the metals out and starting up methylation but stopped when I felt myself circling the drain. Currently doing liver, colon, kidney and parasite cleanses. More about me here.

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